Trust assets are countable; after date of notice of MassHealth ineligibility and prior to appeal hearing appellant transferred assets out of trust for a number of purposes, including to fund a pre-paid irrevocable burial arrangement, and to fund a pooled trust account in her name; transfers made to pooled trust were permissible; transfer to purchase prepaid funeral and burial was also permissible; however, 60-day clock to revise trust to comply with criteria of pooled trust begins when MassHealth issues notice of ineligibility; insufficient information for hearing officer to determine whether additional amounts transferred out of trust were permissible.
Category: Taunton
Appeal 1803632
Community spouse is entitled to her actual MMMNA amount; this amount is based on basic necessities such as shelter and utilities; appellant is on fixed income and has little savings and multiple medical conditions.
Appeal 1803606
- Issue is whether the appellant’s jointly-held real estate should be deemed non-countable. MassHealth ordered to disregard appellant’s jointly-owned real estate from countable assets and to approve the application if otherwise eligible.
Appeal 1800448
MassHealth application denied because verifications not submitted; missing verifications were assets of community spouse; community spouse’s refusal to cooperate with application process cannot be basis for denial of MassHealth application; appellant is mentally incompetent to assign rights of support to MassHealth.
Appeal 1800679
Notice of discharge meets regulatory requirements; nursing facility involved appellant and his guardian in discharge planning; fact that appellant has not found place he wants to live is out of control of nursing facility; physician indicated appellant medically cleared for discharge; place to which appellant will be discharged is safe and appropriate.
Appeal 1800557
MMMNA should be increased because adjustments are needed in the calculations; no exceptional circumstances.
Appeal 1800590
Appellant transferred assets during look-back period; disqualifying transfer; transfers not made for fair market value; evidence needs contemporaneous third party independent corroboration to be persuasive; appellant’s age and health did not support argument that transfers were made for purposes other than qualifying for MassHealth.
Appeal 1713783
Community spouse refused to cooperate; assets have been kept separate; appellant is mentally incompetent and cannot assign to MassHealth any rights to support from her community spouse; application cannot be denied based on spouse’s refusal to cooperate.
Appeal 1706559
- Issue is whether MassHealth was correct in determining that the appellant’s spouse’s assets exceed the limit for MassHealth. Other issue is whether the appellant is allowed to retain the excess assets in order to meet her MMMNA. Appeal is approved.
Appeal 1706272
- Issue is whether MassHealth was correct in determining the appellant’s PPA to the nursing facility. Other issue is whether the appellant’s spouse is entitled to an increased spousal allowance to help pay for a needed stay in an assisted living facility. Appeal is approved.
MassHealth Appeals 